Kan. Admin. Regs. § 28-4-405 - Providers of service
(a) Application.
Each person or corporation desiring to supply services or sell prosthetic
devices, equipment, appliances or supplies shall file an application with the
secretary. Each application shall be approved or disapproved by the secretary,
interested parties shall be notified of the action taken, and a list of
approved providers of service shall be maintained.
(b) Designation of hospitals. Each hospital
approved to provide medical and surgical services for the care and treatment of
eligible persons, except for those out-of-state hospitals authorized by K.A.R.
28-4-408, shall meet the following requirements:
(1) For inpatient services, the hospital
shall meet these standards:
(A) be licensed
as a hospital in Kansas;
(B) be
certified by the joint commission on accreditation of health care
organizations;
(C) have staff
physicians certified by specialty boards in the specialty appropriate for the
needs of the eligible person;
(D)
have available consultation in other specialty areas for the cases being
treated;
(E) have appropriate
operating facilities for the specialty for which the hospital is approved;
(F) have other facilities
appropriate for the application of plaster or other cast material for eligible
persons;
(G) have regularly
scheduled inservice programs relating to children and pediatric conditions; and
(H) provide the following services
for children:
(i) qualified professional
nurses assigned to care of children;
(ii) at least one pediatrician on the
hospital staff, with a designated chief of pediatrics; and
(iii) nonrestrictive visiting hours for
parents and suitable recreational facilities for children.
(2) For outpatient
services the hospital shall comply with the following standards:
(A) Be licensed as a hospital in Kansas;
(B) have an x-ray department with
facilities and qualified personnel to treat children;
(C) have a physical therapy department with
qualified personnel to treat children;
(D) have an occupational therapy department
with qualified personnel to treat children;
(E) have a respiratory therapy department
with qualified personnel to treat children;
(F) have regularly scheduled inservice
programs for all health-care staff relating to children and pediatric
conditions;
(G) have a laboratory
department with facilities and qualified personnel for hematology, chemistry,
microbiology, and serology testing; and
(H) have persons qualified to give
anesthesia.
(c) Designation of laboratory facilities.
Each laboratory facility approved to provide services for the care and
treatment of eligible persons, except for those laboratory facilities
authorized by K.A.R. 28-4-408, shall maintain a valid clinical laboratory
improvement certificate appropriate for the type and complexity of the services
performed.
(d) Designation of
radiology and nuclear medicine facilities. Each x-ray facility approved to
provide services for the care and treatment of eligible persons, except for
those x-ray facilities authorized by K.A.R. 28-4-408, shall meet the following
standards:
(2) have on staff a radiologist supervising
the facility and all patient services;
(3) have on staff technical personnel who are
qualified for the type of services being provided;
(4) have written medical policies and
procedures that are developed and maintained under the direction of the
radiologist responsible for patient services, including policies and procedures
related to interpretation of all radiologic exams, preparation and provision of
written reports, and emergency situations; and
(5) have regularly scheduled inservice
programs for all staff relating to children and pediatric conditions.
(e) Designation of
ambulatory surgical facilities. Each ambulatory surgical facility approved to
provide services for the care and treatment of eligible persons, except for
those ambulatory surgical facilities authorized by K.A.R. 28-4-408, shall
fulfill these requirements:
(1) Be licensed
as an ambulatory surgical facility by the secretary;
(2) have qualified pediatric nurses regularly
assigned to care for the pediatric clients;
(3) have physicians performing the surgeries
who are certified by specialty boards in the specialty appropriate for the
needs of the child and for which the facility is approved;
(4) have dentists who are qualified to
perform the procedures for which the facility is approved;
(5) have qualified personnel to give
anesthesia to pediatric clients;
(6) have a separate area for children with
provisions made for parents who wish to remain with their child during
preparation for surgery and the post-operative period, including the recovery
from anesthesia;
(7) have
facilities to isolate clients with conditions requiring isolation or
separation;
(8) have operating
facilities appropriate for the type of procedures conducted at the facility;
(9) have a laboratory department
with facilities and qualified personnel for hematology, chemistry,
microbiology, and serology testing as appropriate for the type of procedures
conducted at the facility;
(10)
have a radiology department with facilities and qualified personnel to treat
children for conditions related to the type of procedures conducted at the
facility;
(11) have other
facilities appropriate for the type of procedures conducted at the facility;
(12) have regularly scheduled
inservice programs for all health-care staff relating to children and pediatric
conditions;
(13) have written
protocols which state the conditions under which a client would be transferred
to a hospital to receive services not available within the ambulatory surgical
facility;
(14) have written
protocols which state the method of transfer of a client to the hospital, when
necessary; and
(15) have a written
agreement with a hospital to accept a patient transferring from the ambulatory
surgical facility in an emergency situation.
(f) Designation of prosthetics and orthotics
appliance facilities. Each prosthetics and orthotics appliance facility
approved to provide services for the care and treatment of eligible persons
shall have employees certified by the American board for certification in
orthotics and prosthetics, in accordance with the "practitioner certification
book of rules," effective October 1996, and "technician registration book of
rules," revised June 1994.
(g)
Designation of pharmacies. Each pharmacy approved to provide services for the
care and treatment of eligible persons shall be registered as a pharmacy by the
Kansas state board of pharmacy.
(h) Designation of home health agencies. Each
home health agency approved to provide services for the care and treatment of
eligible persons shall be licensed as a home health agency by the secretary.
(i) Designation of other
providers. Other providers approved to provide medical, surgical, and other
services for the care and treatment of eligible persons, except for
out-of-state providers authorized by K.A.R. 28-4-408, shall meet the following
standards.
(1) Each audiologist shall be
licensed as an audiologist by the secretary.
(2) Each dentist shall be licensed by the
Kansas dental board, and each dental specialist shall be licensed to practice
that specialty by the Kansas dental board.
(3) Each hearing aid dealer shall be licensed
by the Kansas board of hearing aid examiners to fit and dispense hearing aids.
(4) Each nurse shall be licensed
as a registered professional nurse by the state board of nursing.
(5) Each nutritionist shall be licensed as a
dietician by the secretary.
(6)
Each ocularist shall be certified by the national examining board of
ocularists, in accordance with the "certification, registration and
recertification," effective 1995.
(7) Each occupational therapist shall be
licensed as an occupational therapist by the Kansas state board of healing
arts.
(8) Each optometrist shall
be licensed by the Kansas board of examiners in optometry.
(9) Each oral surgeon shall be licensed as an
oral surgeon by the Kansas dental board.
(10) Each orthodontist shall hold an
orthodontist's license issued by the Kansas dental board.
(11) Each physical therapist shall be
licensed as a physical therapist by the Kansas state board of healing arts.
(12) Each physician shall be
licensed by the Kansas state board of healing arts. Physicians providing
medical specialty services shall be certified by the appropriate specialty
board within three years of being accepted as a provider for the services for
children with special health care needs program.
(13) Each respiratory therapist shall be
licensed by the state board of healing arts.
(14) Each social worker shall have a master's
degree in social work and shall be licensed by the Kansas behavioral sciences
regulatory board.
(15) Each speech
therapist shall be licensed as a speech therapist by the secretary.
(j) Responsibilities. Each
provider of service shall agree that race, color, religion, national origin or
ancestry shall not be a basis for refusing to provide service. In addition,
each provider shall agree to comply with the following requirements:
(1) Submit reports requested by the services
for children with special health care needs program;
(2) accept responsibility for the care and
treatment provided to persons under the services for children with special
health care needs program;
(3) be
a medicaid provider;
(4) accept
and bill insurance and medicaid, when available;
(5) accept as payment in full, payment from
medicaid for medicaid-eligible services, without receiving a supplement from
the services for children with special health care needs program;
(6) accept as payment in full, payments from
an insurance carrier for services covered under a policy, supplemented to equal
the services for children with special health care needs allowable rate, when
applicable;
(7) accept as payment
in full the fees established by the secretary and shall not bill families for
any service covered by the services for children with special health care needs
program without permission of the secretary; and
(8) notify the secretary of withdrawal from
the services for children with special health care needs program.
Notes
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